Can’t Afford to get sick? Think Again!

An editorial about consumer-driven health care plans (CDHPs) in the Roanoke Times & World News contends, “Americans’ penchant for bargains permits them to think they are capable of garage-sale haggling with an emergency room cardiologist while feeling as though an elephant is sitting on their chests.” But is this really accurate?

Consider this: Consumer health plans are not designed to require a patient to shop around during an emergency. Rather, they empower patients to know their marketplace beforehand, so that in an emergency the patient knows where he or she feels most comfortable receiving care. Further, the freedom created within the consumer-driven model means that during an emergency a patient can act on personal choice or go to the medical facility that makes the most geographic sense, rather than being forced to seek treatment within a specified network as with traditional insurance plans.

The editorial adds, “For Americans to be sold on the value of health savings accounts [HSAs], they will need to remain relatively ignorant of what they are buying.” On the contrary, the consumer-driven model is all about educating the patient, not keeping them uninformed. An educated patient can better understand health care and health costs and then take the reins, making decisions that ultimately have a positive effect on both the system and the patient. Reports from insurance companies’ first-year HSA offerings prove that these models do work and are successful in driving down health care costs. The value of that kind of cost savings is evident.

“What the banks won’t emphasize, as they earn returns on health investment accounts, is that account holders can’t afford to become sick,” the article continues. “The switch from traditional health plans in which insurance companies negotiate fees will cost individuals dearly, and not just in the thousands of dollars a year in out-of-pocket expenses in addition to premiums for catastrophic health plans.”

However, was there ever a time when a consumer could afford to get sick? The cost of illness has never been of more concern than it is today with 45 million Americans having no insurance and health care costs spiraling upward with several years of double-digit growth. This is precisely the reason some would argue that the system needs the new consumer-driven model where it is possible to save on the front end and over the long haul.

Both a traditional plan and a CDHP require some out-of-pocket expenses, but an HDHP (high deductible health plan) with an HSA has proven about 43% savings each year over a traditional plan based on premiums alone. That leaves substantial pre-tax dollars that can be put away for a health situation in the future.

The editorial writer asserts that HSAs will have a negative impact. “The [health savings] accounts also will exact a toll on health, as patients scout out the cheapest, and not necessarily the best, healthcare, or brush off doctors’ orders because procedures are too costly.” HSAs do not negatively affect people’s health; being afraid to go to the doctor for financial reasons is what causes harm. Some would argue that the thousands of uninsured people who go without medical treatment because they can’t afford it are a result of the traditional health care system which has prioritized up front, high dollar premium payments over actual medical treatment.

And, even among the insured, there are many who elect to brush off doctors’ orders because the treatment is not covered by insurance, or the co-pay is too expensive. Studies show that HSA participants are no more likely to abstain from care than any other patient, and are more likely to look into preventative and wellness care and think through the relative cost of treatment options.

HSAs set the patient up to save money on premiums, to set aside pre-tax money to pay for out-of-pocket expenses, and to pay with cash when the time comes. That means savings on the front end, tax savings throughout the year, and the negotiating power of cash at the point of service. Consumer-driven health care creates choices for Americans and forces consumerism into health care. It drives down costs for each and every transaction, and can likely be considered an inspiring new innovation in the industry.